Fungi and parasites_student.pptx

Fungal Infectio ns CHAPTER 24 MATTHEW MOEHL, PHARMD HTTPS://SPONGEBOB.FANDOM.COM/WIKI/ FUNGUS_AMONG_US Intro to Fungi Fungi ◦ Molds, Yeasts ◦ Dermatophytes; Dimorphic Found in soil, decaying plants, and some are human flora Severe and life-threatening cases most often in immunocompromised HTTPS...

Fungal Infectio ns CHAPTER 24 MATTHEW MOEHL, PHARMD HTTPS://SPONGEBOB.FANDOM.COM/WIKI/ FUNGUS_AMONG_US Intro to Fungi Fungi ◦ Molds, Yeasts ◦ Dermatophytes; Dimorphic Found in soil, decaying plants, and some are human flora Severe and life-threatening cases most often in immunocompromised HTTPS://WWW.AMS.USDA.GOV/SITES/DEFAULT/FILES/ MEDIA/YEAST%20TR%20HANDLING%201-2214%20FINAL.PDF Types of Fungi Aspergillus Blastomycosis Candidiasis ◦ Candida albicans Coccidioidomycosis – southwest U.S. and northern Mexico Histoplasmosis – central and Mideastern U.S. Cryptococcus Pneumocystosis Oral candidiasis, or “thrush” HTTPS://HEALTH.CLEVELANDCLINIC.ORG/THRUSH-THEWHITE-STUFF-GROWING-IN-YOUR-MOUTH-AND-HOW-TOGET-RID-OF-IT/ Polyenes • Prototype: amphotericin B deoxycholate (Fungizone) • Mechanism of action: disrupts membrane, stopping reproduction • Use(s): • (BBW) Reserved for potentially fatal infections • Nursing considerations: • “ampho-terrible” • Renal impairment common • Keep hydrated with IV sodium chloride • Organ failure, cardiac arrest, respiratory arrest • Premedicate • Separate IV line and use filter Lipid formulation • Abelcet, AmBisome • Less nephrotoxic • Do not use inline filter https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=f7be65064d20-401e-a0ff-02ad7c33158a&type=display Example question A client is about to receive amphotericin B for a severe fungal infection. Which of the following is important for the nurse to consider prior to administration? (check all that apply) A. a filter needs to be used if giving the non-lipid formulation B. premedicate the client to limit side effects postadministration C. hydrate with IV sodium chloride to limit renal damage D. a filter needs to be used if giving the lipid formulation Azoles (-conazole) • Prototype: fluconazole (Diflucan) • Mechanism of action: disrupts membrane permeability • Use(s): • Drug of choice for candida infections • Nursing considerations: • Half dose if poor renal function • Hepatotoxicity • Enzyme inhibitor • Watch for drug Reminder: Enzyme inhibitor = interactions decreased drug metabolism = increased effects of some drugs = increased risk of toxicity Pyrimidine analog Amp B • Prototype: flucytosine (Ancobon) • Mechanism of action: affects cell membrane, resulting in cell death • Use(s): • Adjunct with Amp B for candida and cryptococcus. flucytosine • Nursing considerations: • BBW for caution in renal impairment • Hepatotoxicity and bone marrow toxicity • Monitor labs closely to adjust dose Example question A client has a severe cryptococcus infection, and the physician is considering the use of flucytosine. Which medication must flucytosine be paired with for this client? A. fluconazole B. lamivudine C. amphotericin B D. gentamicin Parasitic Infections CHAPTER 25 MATTHEW MOEHL, PHARMD Intro to Parasites Living organism that survives at the expense of another organism, called “the host” Range from minor to major in severity Caused by protozoa, helminths (worms), scabies, and pediculi (lice) No vaccines HTTPS://TVSERIESFINALE.COM/TV-SHOW/MONSTERSINSIDE-SEASON-EIGHT-COMING-ANIMAL-PLANET-OCTOBER/ Parasitic Infections Amebiasis ◦Amebic dysentery Malaria ◦Fever, chills, return to “normal” Helminthiasis Pediculosis (Lice) Scabies Amebicides • Prototype: metronidazole (Flagyl) • Mechanism of action: diffuses across cell membrane, resulting in cell death • Use(s): • Intestinal amebiasis • trichomoniasis https://www.cdc.gov/parasites/amebiasis/index.html • Nursing considerations • Metallic taste, dark urine • Avoid alcohol (disulfiram) • During treatment and 3 days after • Assess stools for less diarrhea Antimalarials (-quine) • Prototype: chloroquine • Nursing phosphate (Aralen) • Mechanism of action: interferes with parasite DNA, RNA, and metabolism • Use(s): • Treatment and prophylaxis (ppx) of malaria https://insectcop.net/anopheles-mosquito/ considerations • Visual disturbances • Electrocardiogram changes • Take weekly (same day) for ppx; daily for treatment. Example question A client is prescribed metronidazole for trichomoniasis. What is an important counseling point for the nurse to teach the client? A. take once weekly for malaria prophylaxis B. do not drink alcohol during treatment C. do not drink alcohol during treatment and 3 days after D. may experience visual disturbances, such as difficulty focusing Anthelmintics • Prototype: mebendazole (Enverm) • Mechanism of action: blocks glucose uptake • Nursing considerations • Chew / crush and swallow • Teratogenic • Use(s): • Worms (pinworm, hookworm, roundworm, whipworm) https://www.medicinenet.com/pinworm_infection/article.htm; https://biologywise.com/roundworm-facts Pinworms • Enterobius vermicularis • Disinfect toliets after use • Clean clothes, sheets, towels, daily • Treat family members… very contagious • Perianal itching… • Handwashing https://www.cdc.gov/dpdx/enterobiasis/index.html Scabicides and Pediculicides • Nursing considerations permethrin (Elimite, • Topical Nix) • Lice • Mechanism of • Wash hair, apply cream, let it sit action: for 10 minutes, rinse with water, use lice comb. • Stops influx of • Prototype: sodium, thus Paralyzes and kills the parasites • Use(s): • lice and scabies • Repeat in 1 week if still present • But keep drug on hair overnight • Scabies • Apply head to toe and leave on for 8-14 hours https://www.walmart.com/ip/Nix-Lice-Killing-Creme-Rinse-Family-Pack-Nit-Combs/10316456? wmlspartner=wlpa&selectedSellerId=0&adid=22222222227000011892&wl0=&wl1=g&wl2=c&wl3=40842753992&wl4=p la58650937553&wl5=9026806&wl6=&wl7=&wl8=&wl9=pla&wl10=8175035&wl11=online&wl12=10316456&veh=sem&gc lid=Cj0KCQiAqNPyBRCjARIsAKA-WFzWi1066KSYhCk_xoKocpcJFTlJGlKEN2jJaj2wa4aznHLtno7C5FYaAm3NEALw_wcB https://www.youtube.com/watch?v=IxA59er WM5w Example Questions A client receives a diagnosis of enterobiasis, an infection with Enterobius vermicularis. What is E. vermicularis? A. pinworm B. hookworm C. whipworm D. roundworm A client’s child has a lice infection. Which statement reflects accurate teaching for the client? A. the treatment is taken by mouth B. apply medication from head to toe C. nits are easy to remove D. repeat in one week if nits still present The End